Susan T Jackson, PHD, MSC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

480 Issued in KS

Practice address

3901 Rainbow Blvd MSC 4043
2032 School of Nursing
Kansas City, KS 66160-0001

Phone

(866) 249-9736

NPI assigned

Aug 26, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1255449658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "STILWELL",
            "state": "KS",
            "postal_code": "660850307",
            "telephone_number": "913-522-4894",
            "fax_number": "713-344-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD MSC 4043",
            "address_2": "2032 SCHOOL OF NURSING",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661600001",
            "telephone_number": "866-249-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUSAN",
        "middle_name": "T",
        "credential": "PHD, MSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-26",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND. BCBS PROVIDER NUMBER",
            "identifier": "18427026",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quinn Michelle Jackson, M.D.
• Randolph Thomas Jackson, M.D.
• Robert Sean Jackson, M.D.
• Sara Jackson, LSCSW
• Seth Jackson, DPT
• Tara L Jackson, APRN
• Victoria Jackson, CNA
• James Seth Jacob, MD
• Megha Lilly Jacob
• Jacob'S Well Holistic Services, LLC

• Speech-Language Pathologist in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Speech-Language Pathologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.